University of North Dakota UND Scholarly Commons Theses and Dissertations Theses, Dissertations, and Senior Projects January 2016 New Mothers' Perceptions Of Breastfeeding, The Transition To Parenthood, And The aP rtner Alliance: A Grounded Theory Study Jennifer Amy Munch Follow this and additional works at: https://commons.und.edu/theses Recommended Citation Munch, Jennifer Amy, "New Mothers' Perceptions Of Breastfeeding, The rT ansition To Parenthood, And The aP rtner Alliance: A Grounded Theory Study" (2016). Theses and Dissertations. 2051. https://commons.und.edu/theses/2051 This Dissertation is brought to you for free and open access by the Theses, Dissertations, and Senior Projects at UND Scholarly Commons. It has been accepted for inclusion in Theses and Dissertations by an authorized administrator of UND Scholarly Commons. For more information, please contact [email protected]. NEW MOTHERS’ PERCEPTIONS OF BREASTFEEDING, THE TRANSITION TO PARENTHOOD, AND THE PARTNER ALLIANCE: A GROUNDED THEORY STUDY by Jennifer A. Munch MA, University of North Dakota, 2012 BA, University of British Columbia, 2006 A Dissertation Submitted to the Graduate Faculty of the University of North Dakota In partial fulfillment of the requirements for the degree of Doctor of Philosophy Grand Forks, North Dakota December 2016 Copyright 2016 Jennifer A. Munch ii iii PERMISSION Title: New Mothers’ Perceptions of Breastfeeding, the Transition to Parenthood, and the Partner Alliance: A Grounded Theory Study Department: Counseling Psychology Degree: Doctor of Philosophy In presenting this dissertation in partial fulfillment of the requirements for a graduate degree from the University of North Dakota, I agree that the library of this University shall make it freely available for inspection. I further agree that permission for extensive copying for scholarly purposes may be granted by the professor who supervised my dissertation work or, in her absence, by the Chairperson of the department or the dean of the School of Graduate Studies. It is understood that any copying or publication or other use of this dissertation or part thereof for financial gain shall not be allowed without my written permission. It is also understood that due recognition shall be given to me and to the University of North Dakota in any scholarly use which may be made of any material in my dissertation. Jennifer A. Munch November 22, 2016 iv TABLE OF CONTENTS LIST OF FIGURES ....................................................................................................... x LIST OF TABLES ......................................................................................................... xi ACKNOWLEDGEMENTS ........................................................................................... xii ABSTRACT ................................................................................................................... xv CHAPTER I. INTRODUCTION .................................................................................... 1 II. LITERATURE REVIEW ......................................................................... 8 Breastfeeding ..................................................................................... 9 Infant Benefits of Breastfeeding ................................................ 10 Maternal Benefits of Breastfeeding ........................................... 10 Economic and Community Benefits of Breastfeeding............... 11 Disadvantages of Breastfeeding ................................................. 12 Prevalence of Breastfeeding ...................................................... 13 Breastfeeding Barriers ............................................................... 15 Breastfeeding Facilitators .......................................................... 19 Partner Involvement in Breastfeeding ....................................... 22 Transition to Parenthood and Relationship Satisfaction ................... 29 Limitations of the Transition to Parenthood Research .............. 38 Close Relationship Theories .............................................................. 39 v Role Strain ................................................................................. 39 Relationship Maintenance Theory ..................................................... 40 Attachment Theory .................................................................... 41 Limitations of Relationship Satisfaction Research .................... 43 Breastfeeding and Relationship Factors..................................... 44 Breastfeeding and Sexual Functioning and Intimacy ........................ 50 Grounded Theory .............................................................................. 54 Purpose .............................................................................................. 59 III. METHOD ................................................................................................. 63 Participants ........................................................................................ 63 Measures ............................................................................................ 65 Research Team .................................................................................. 66 Procedure ........................................................................................... 67 Data Collection .......................................................................... 69 Interview Questions ............................................................. 71 Transcription .............................................................................. 72 Data Analysis ............................................................................. 72 Theoretical Sampling and Saturation ......................................... 75 Safeguards .................................................................................. 76 IV. RESULTS ................................................................................................. 81 Domain 1: Breastfeeding ................................................................... 87 The Decision to Breastfeed ........................................................ 87 Expectations ............................................................................... 90 vi Initial Experiences: “How to get Things in the Right Place” .... 90 Ongoing Struggles ..................................................................... 94 “Everything got Better and Easier” ............................................ 99 “Breastfeeding Changes how your Body gets to Interact With the World” ......................................................................... 99 Perseverance: “Willing to go through Any and All Pain” ......... 103 Commitment to Continuing ....................................................... 107 Facilitating Factors..................................................................... 107 Cultural Influences ..................................................................... 108 Breastfeeding in Public .............................................................. 109 Body Image: Aversion, Acceptance and Appreciation .............. 110 Work: Issues with Accommodations and Identity ..................... 116 Domain 2: Transition to Parenthood ................................................. 118 Coordinating a New Routine ..................................................... 118 Outside Support ......................................................................... 119 Positive Experiences .................................................................. 120 “Adding this Third Life into our Relationship: Finding the Extra Love and Energy”............................................................. 120 Striving for Balance ................................................................... 123 Figuring it Out............................................................................ 125 Intentional Communication ....................................................... 128 Teamwork: “When Things are Really Good, Everything is Just in Sync” .............................................................................. 131 Conflict ...................................................................................... 136 vii Intense Mood and Anxiety ......................................................... 139 Minimization of Distress............................................................ 140 Domain 3: Interaction of Breastfeeding and the Partner Relationship ....................................................................................... 140 Impact of Breastfeeding on Physical Intimacy .......................... 141 Impact of Breastfeeding on Emotional Intimacy ....................... 152 Partner Emotional and Practical Support of Breastfeeding ....... 154 Partner’s Lack of Support of Breastfeeding ............................... 163 Summary of Results .......................................................................... 166 V. DISCUSSION ........................................................................................... 168 Alignment and Attunement: How the Partner Relationship Facilitates Breastfeeding and Family Cohesion ................................ 169 Second Literature Review ................................................................. 179 Getting on Board: The Decision to Breastfeed ................................. 180 Family Influences on Breastfeeding .......................................... 180 Partner Attitudes